Friday, September 23, 2016 Summer's Over, but Payment Reform is Just Beginning: Tips on Getting Up to Speed A new proposed CPT system for evaluation codes, increasing required bundled payment models, the end of the Physician Quality Reporting System (PQRS) in favor of the Merit-Based Incentive Payment System (MIPS)…feeling dizzy yet? Health care reform's swift movement toward value-based payment and away from procedural-based, fee-for-service systems is sweeping up physical therapists (PTs) and physical therapist assistants (PTAs) as it continues to gain momentum. And that momentum built over the summer, even while we vacationed, mowed our lawns, and got the kids ready for another school year. So now that it's officially fall, why not spend some time getting up to speed on where the profession stands in relation to payment reform? Here are a few suggestions to help you find out what health care did over your summer vacation: See the big picture on payment reform. The "Compliance Matters" columns, a regular feature of PT in Motion magazine, connect you with what's going on. Check out the August column, which lays out the basics behind the Center for Medicare and Medicaid's proposed system for new CPT evaluation codes (and 1 reevaluation code), as well as the column from March that explains the workings of the new Comprehensive Care for Joint Replacement (CJR) bundling program. For an even bigger-picture view of the road that has led to the CPT and other changes, this article from the April issue of PT in Motion magazine provides 5 concepts that are central to payment reform. Dig a little deeper. The newly updated APTA Payment Reform webpage is the jumping-off point to 3 major areas that affect—or will soon be affecting—PTs and PTAs: alternative payment models, Medicare postacute care reform (especially the reform efforts reflected in the IMPACT Act), and the changes associated with the Medicare Access and CHIP Reauthorization Act, or MACRA. All 3 areas contain multiple resources and links that can help you see where things stand now, and where they may be headed. Another resource for some in-the-weeds information: APTA's Insider Intel series, a phone-in program that puts you in touch with staff experts on payment reform. Past intel calls are available as recordings or transcripts; look for another installment later this fall. Get a handle on where things stand right now. The proposed 2017 Medicare physician fee schedule from CMS is the hot topic of the moment. While awaiting the final rule (expected in late October/early November), find out what it's all about and what changes could impact PTs the most through the recording of a sold-out webinar on the payment system held September 22. You can also access the most recent APTA summary of the proposal (look under "APTA Summaries"). And while you're in a summary state of mind, don't miss out on APTA summaries of the final 2017 inpatient prospective payment system (IPPS) rule, the proposed rule for the 2017 home health prospective payment system, and the final rule on the 2017 skilled nursing facility prospective payment system—all can be found under the "APTA Summaries" header on their respective pages. Want a quick video take? These video dispatches from the APTA State Policy and Payment Forum—on bundled care models and the proposed CPT coding system—provide brief overviews. Find out what your association has to say. APTA registered its "deep disappointment" with the CMS decision to employ a 3-tiered CPT evaluation system that doesn't differentiate payment among those tiers, but that's not all the association had to say about the proposed 2017 physician fee schedule: you can read the association's comments to CMS in their entirety at the APTA Medicare Physician Fee Schedule webpage (look under the "APTA Comments" header). Then be sure to get the perspective of APTA President Sharon L. Dunn, PT, PhD, who issued a recent statement and update that outlines APTA's efforts around payment reform, and urges members to engage in this issue so that the profession can have a role in shaping the future of payment.